Medical training therapy

Dr satbir singh
SPORTS MEDICINE CONSULTANT
FITNESS TRAINER
What does Rehabilitation
Training Mean?
 After Surgery/injury
Physiotherapy by it self’s is
not sufficient to achieve full
Recovery ?
 Importance of active neuromuscular Rehabilitation

MTT Training improves basic motor capabilities

Endurance

Muscle
Coordination
Strength
Physical
condition

Speed Mobility
Flexibility

Source: modified from Einsingbach 1988

 Rehabilitation Training

1. Phase 2. Phase 3. Phase 4. Phase

- Isometric strength - Isometric Strength - General Strength - Sprint

- General flexibility - Complex exercises training - Endurance
- Coordinative training - Isokinetic Exercise - Isokinenetic Exercise - Plyometrics
- Easy circuit - General Strength training - Return to easy - General Strength
- Aqua training sportspec. Skills Training
- Aqua training - Sports Specific
- Step up the skill training
Muscle training - Swimming
- Jogging
 Diagnostic and Testing
 What can we Test
 How can we Test
 When can we Test
 Why we have to Test
 Where we have to Test
 Medical training therapy (MTT) - from Evaluation to Training

MTT Treatment – Exercise Therapy

Medical Training Therapy:

A systematic way

TEST TRAINING

Evaluation of current Status – Examination

 deficit Aanalysis

Definition of Treatment Goals

Training plan

MTT Training: application of Principles, Methods for

Training in Therapy
 Medical training therapy (MTT) - from Evaluation to Training

Evaluation of current Status – Examination

 deficit Analysis

Examination Physiotherapist and Physician/MD:

Range of motion
Joint function
Swelling? Inflammation?
Pain situation
Limitations
Functional status
Etc.

Examination and Diagnostics MTT:

Muscular status – Strength Test
Coordination
Speed
Flexibility
Endurance
etc.
ACUTE CARE : SOFT TISSUES
INJURY
 Medical support in MTT
 PRICE: MINIMISING THE EXTENT OF INJURY
 IMMOBILISATION/ EARLY MOBILISATION
 THERAPEUTIC DRUGS
 MECHANOTRANSDUCTION
 IONTOPHORESIS
 NITRIC OXIDE DONOR PATCH
 VISCOSUPPLEMENTATION
 S-ADENOSYL METHIONINE.
 MECHANOTRANSDUCTION
 EXC CAUSES SLIDING
OF COLLAGEN FIBRES
 INCREASED COMM”N
VIA GAP JUNCTIONS
AND CELL NUCLEUS.
 UPREGULATION OF
PROTIEN SYNTHESIS
 S- ADENOSYL METHIONINE
 ENHANCES THE CARTILAGE GROWTH
 LONG TERM PAIN RELIEF
 EXERTS GASTROPROTECTIVE EFFECTS
 1 WEEK: 400 MG TDS
 2 WEEK: 400 MG BD
 3 WEEK: 200 MG BD
PHYSIOTHERAPY MODALITIES
 CRYOKINETICS
 CONTRAST BATH
 HEATING MODALITIES
 ULTRASOUND
 ELECTROTHERAPY
 LASER
 MANUAL THERAPY
 Medical training therapy (MTT) - from Evaluation to Training

MTT Training:
application of principles, methods for Training ( Therapy )

Training Session 90-120 min

Warming Up

Stretching

Coordination training

Strength training

Cardio Endurance training

Cool down
 1.Phase : Early Mobilization
1. Training target 2. Training form

- Reduction Muscle Atrophy - Stretching

- Improvement of Muscle Strength - Complex - exercises

- Development Coordination

- Improvement of Flexibility

- Circulation Training

3. Method of the training 4. Training volume

- Isometric Training - 60 to 120 min

- Strength Training
 2. Phase: Stability
1. Training targets 2. Training form

- Improvement of endurance - Ergometer-Training on

Ergometer
- Improvement of strength endurance - “Complex gymnastic”
- “motion skills”
- Improvement of coordinative (e.g. walking )
abilities -“Complex-exercise”
- Aqua training
- Spec.exercise for Knee-
3. Method of the training coordination

- Isometric training

- Muscle training (Strength training) 4. Training volume

- Isokinetic training - 120 to 180 min per day

 3. Phase: Muscular
1. Training target 2. Training form

- Improvement of flexibility - on ergometer Training

- Improvement of agility - “Complex gymnastic”

- Improvement of Reactive abilities - Running on soft mattress

- Return to sportspec.skills - Coordination Runs

3. Method of the training
- Aqua-jogging
- Isometric training
4. Training volume
- General Strength training
- Two training sessions per day
- Interval training

- Complex training
BALANCE AND PROPRIOCEPTION
 SAMPLE EXERCISES
 BALANCE BOARD
 SWISS BALL
 DURA DISK
 MINITRAMPOLINE
POWER AND STRENGTH
FLEXIBILITY TRAINING
 DAPRE
 DAILY ADJUSTED
PROGRAMME OF
RESISTANCE
EXERCISES
 ONE RM ( REP MAX)

 Formula:[ (r/30) + 1 ] x w
 R: number of repetitions performed.
 W: weight lifted for that exercise.
1 RM CALCULATOR CHART
 4. Phase: Muscle Load Training
1. Training target 2. Training form

- Improvement of speed endurance - Jogging

- Improvement of strength - Striding

- Re -integration into team - Sprints

- Mental Fitness - Aqua-jogging

3. Method of the training
4. Training volume
- Test
- Two training sessions per day
- Bounding (Series)

- Speed training

- Endurance training
CARDIOVASCULAR CONDITIONING
 KARVONEN’S
FORMULA
 MHR= 220-AGE
 HRR: MHR-RHR
 AEROBIC ZONE: 40-
70% X HRR + RHR
 ANAEROBIC ZONE:
70-95% HRR + RHR
 Important Factors for optimal
Rehabilitation
 Healing of the wound  The five phases of
must be without any ”Rehabilitation Training”
complication should be carried without
 Physiotherapy starts mistakes
immediately after the OP
 Close co-ordination
and also reha Training
between doctor, physio
 Sufficient nutrition ,
specific supplements: and sporttherapist
proteins, vitamins,  Consensus between
minerals etc.to develop physio and rehab-
the muscle training with regard to
the schedule of execution
Thank you